Explosive blast traumatic brain injury(bTBI) can be a complicated thing, doctors have learned. The Centers for Disease Control and Prevention have determined secondary, tertiary, and even quaternary effects that may contribute to a particular patient’s condition.
The primary injury comes from the forces created by the explosion itself. Secondary injury might occur due to matter thrown by the explosion, like fragments from the weapon itself, or debris in the immediate environment. Tertiary injury like skull fractures occur when the victim is thrown by the blast to strike a wall or the ground. Finally, quaternary injuries may occur from factors not included in the first three, like burns or inhalation of toxic fumes.
Doctors have seen that the injuries can cause a number of symptoms. It might be as mild as a brief period of confusion – or it may lead to a coma. Severe bTBI commonly leads to diffuse cerebral edema and hyperemia, developing rapidly, within an hour after the initial blast injury. This type of injury seems to be much more common with blasts, as opposed to other forms of traumatic brain injury, and this type of injury has lead to military neurosurgeons performing more decompressive craniectomies more often than they would for penetrative traumatic brain injury (pTBI) or closed head traumatic brain injury (cTBI).
There is a challenge for hospitals in Queens and Staten Island in finding a unique clinical description for bTBI. The data is still coming in when it comes to the specific details of this type of injury. Those who suffer from bTBI also have other serious injuries, such as traumatic limb amputation and hemorrhagic shock.